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Platinum Visitors Cover

 
Inclusive of GST

Payment

Excess:

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Excess

An excess is a set amount you agree to pay upfront before your benefit is paid for overnight or same-day admissions at any hospital. If your cover has an excess you will need to pay it once per person per calendar year to a maximum of twice on the entire membership. There is no excess if your child is admitted to hospital.

Extras Paid Back*:

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Extras Paid Back

You can budget how much you'd like to pay for your monthly premium by choosing how much you want to claim back from your visits for most items at Members First providers covering dental, optical, physio and chiro. Annual maximums and waiting periods apply.

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Includes:

  • Platinum Visitors Cover $0.0
  • Platinum Visitors Cover extras $0.0
  • Pharmacy Saver (weekly) $0.45

Features at a glance

Hospital Cover
      TOP
Extras Cover
      TOP
back on extras*
Price is based on cover for: status, age, stateChange
*For most items at Members First providers, covering general dental, physio, chiro and podiatry services. Annual maximums, waiting periods and fund rules apply.

About this cover

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Important changes to this health cover

How we define and cover different treatment types under this cover will change in 2018. It is important that you are aware of these changes. To find out more, read the change overview.

Provides top-level private hospital and medical cover with no excess and meets the health insurance requirements of any working visa, including the 457, 482 working visa. You'll enjoy a combination of comprehensive cover for private hospital and medical expenses, and visits to a doctor or specialist in private practice, plus Extras cover. Plus, you have an option to add an excess for hospital admissions to help reduce your premium.

This cover provides top-level benefits for extras services including dental, optical, physiotherapy and more.
View Extras Cover

Download Product Summary

Hospital

Benefits included on cover:
Accommodation for overnight and same-day stays
Operating theatre, intensive care, ward fees
Bupa Medical Gap Scheme available
Allied services (eg physiotherapy in hospital)
Private hospital admissions
Public hospital admissions
Inpatient medical expenses - 100% of AMA
Outpatient medical expenses - 150% of MBS
457, 482 visa compliant

Inpatient services included on cover:
Pregnancy and birth related services
IVF and assisted reproductive services
Cosmetic Surgery
Bone marrow transplants
Organ transplants
All other inpatient treatments receiving a Medicare benefit

Additional Items:
Outpatient pharmacy benefits*
100% emergency ambulance services
Repatriation benefits
Family in-hospital benefit that helps pay for in-hospital partner/family accommodation or meals
Crutches and wheelchairs benefit
Cover for extras services (e.g. dental, optical, physiotherapy)
Reimbursement on emergency department facility fees charged at any private or public hospital
including administration fees even if not admitted to hospital

Excess options: Nil, $500
Legend:    Glossary
Covered
Not covered
AMA Fee Australian Medical Association Fee
MBS Fee Medicare Benefit Schedule Fee
*you pay $20, we refund a 90% of balance per script per item up to $600 per person
per calendar year

Important product changes in 2018

Why are we making these changes?

We have listened to our customers and we know that Health Insurance is confusing. Our changes are intended to make health insurance easier to understand, and to improve the value and affordability of cover.

What are the changes

Changes from 1 July 2018
Impacted treatment type or feature Description
Clinically Necessary Cosmetic Surgery From 1 July 2018, we’re updating our Overseas Visitors Rules to clarify the definition of Cosmetic Surgery so you have a better idea of what is excluded and deemed as Cosmetic Surgery.
Changes from 1 August 2018
Change type Description
Bupa Medical Gap Scheme ?

Our medical gap scheme helps you reduce the medical costs you pay yourself for in-hospital treatment. From 1 Aug, this will only apply in Members First, Network and Fixed Fee Hospitals. Find one of these hospitals or a Medical Gap Scheme provider here.

Where the Medical Gap Scheme applies is changing.

What is covered?

Hospital costs

With private hospital cover, you can choose to be treated as a private patient in either a public or a private hospital.

What if I am treated in a Members First or Network Hospital?

Depending on your level of cover you are fully covered as a private patient in most hospitals that Bupa has an agreement with known as Members First and Network hospitals across Australia for any treatment which is recognised by Medicare and is not either restricted or excluded under your cover.

A small number of these hospitals may charge a fixed daily fee, capped at a maximum number of days per stay. The hospital should inform you of this fee when you make a booking. This fee is in addition to any excess you may have as part of your hospital cover.

When admitted to hospital, in most cases you will be covered for in-hospital charges when provided as part of your in-hospital treatment including:

  • accommodation for overnight or same-day stays
  • operating theatre, intensive care and labour ward fees
  • reimbursement on emergency department fees charged at any private or public hospital including administration fees if admitted into hospital (or in all circumstances depending on your level of cover).
  • supplied pharmacy items approved by the Pharmaceutical Benefits Scheme (PBS)
  • physiotherapy, occupational therapy, speech therapy and other allied health services
  • a surgically implanted prosthesis up to the Government minimum benefit published in the Government's Prosthesis List
  • private room where available.^

^Conditions apply. Contact us for more information.

Members First day facilities

If you are treated in a Members First day facility, there are no out-of-pocket expenses for medical services (eg your specialist’s fees). (Any co-payment or excess related to your level of cover will still apply).

We recommend you call us first before making a booking to confirm that your hospital of choice gives you certainty of full cover. We can also discuss any excess that may be applicable to your level of cover. You can find out if a hospital has an agreement with us by checking bupa.com.au/find-a-provider.

What happens if I choose to be a private patient in a public hospital or go to a private hospital that doesn't have an agreement with Bupa?

With us, if you elect to be treated as a private patient in a public hospital or are admitted to a non-agreement private hospital, you are covered as set out below for any treatment recognised by Medicare unless it is excluded or restricted under your cover. If you choose to be treated as a private patient in a public hospital you are entitled to choose your doctor, if they are available. Depending on your illness or condition, this may be the same doctor who would have been allocated to you by the hospital as a public patient.

In a non-agreement private hospital, you are responsible for the cost of your stay and may be charged directly for your hospital accommodation, doctor's services (including diagnostic tests), surgically implanted prostheses (eg artificial hips) and personal expenses such as TV hire and telephone calls. Some of these hospitals bill Bupa directly for the benefits we pay for your hospital stay under your policy.

The amount we will pay towards your accommodation in a non-agreement private hospital is limited to a minimum shared room benefit. For a non-agreement private hospital this will only partially cover the full cost and you will have significant out-of-pocket expenses. If you request a single room in a non-agreement private hospital, and you receive one, you will incur out-of-pocket expenses as the hospital may charge you more for the room than the benefit that Bupa pays. It is important to note that in public hospitals, single rooms are generally allocated to people who medically need them the most. If required we will also cover any prostheses that are surgically implanted in you during your hospital stay up to the minimum benefit listed on the Government's Prostheses List.

We will cover you for your in-hospital medical costs incurred during an admission in public or non-agreement hospital in the same way as set out under the heading "Inpatient Medical Costs" below.

The hospital and the treating doctor should let you know what you'll be billed for and how much you will be charged, ie they should obtain your Informed Financial Consent before you receive the treatment – if they don't, make sure to ask for full details. Call us to confirm what benefits we'll pay for your public hospital or non-agreement private hospital stay.

Inpatient medical costs

These are the fees charged by your doctor, surgeon, anaesthetist or other specialist for any treatment given to you when you are admitted to a hospital as an inpatient. Put simply, we pay 100% of a schedule fee or 100% of the cost of inpatient medical fees. Depending on your level of cover, we cover you for either the Australian Medical Association (AMA) Schedule fee or the Medicare Benefits Schedule (MBS) fee, or the full cost of treatment. The schedule fees mentioned above are the fees determined by the AMA and the Federal Government respectively, as the appropriate fee for a specific service.

Please check your product summary to determine the benefits that apply.

Outpatient medical costs

This is cover for any treatment you receive from a doctor or specialist in private practice, or as an outpatient (ie where you are not admitted into hospital) anywhere in Australia.

Depending on what is set out in your level of cover we cover you for 100% to 150% of the Medicare Benefits Schedule (MBS) fee or 100% of the MBS Scheduled fee for Outpatient costs. The MBS fee is set for each specific service by the Federal Government. Outpatient medical cover is available on most of our visitors covers. Please check your product summary to determine the benefits that apply.

Outpatient pharmacy benefit

You can also receive benefits on selected pharmacy items prescribed as an outpatient or by a doctor or specialist. Please check your product summary to determine the benefits that apply. A co-payment of $20 applies.

Repatriation benefit

You will receive cover for repatriation to your country of origin if you become terminally ill or if you suffer a substantial life altering illness/injury up to $100,000. Or for the return of mortal remains up to $10,000. Benefits are only payable once approved by Bupa.

No Repatriation Benefit will be paid if you were:

  • first diagnosed as terminally ill
  • a reasonable person would have first become aware of the terminal illness
  • if you suffered a substantial life altering illness or injury within the six months prior to the date your cover commenced.

Family In-Hospital Benefit

You could receive benefits for accommodation and meal costs if your partner, immediate family member, carer or next of kin is required to stay at hospital with you or a person on your membership. They will be covered for $60 per night for accommodation in hospital and up to $30 a day for hospital meals.

Hospital meals are covered when provided at a hospital cafeteria or patient meal menu. A $1,000 per person, per calendar year annual maximum applies to Family In-Hospital Benefit.

Crutches and wheelchairs benefit

You will receive a benefit for crutches and wheelchairs.

For a benefit to be payable, the hire or purchase must be linked to an inpatient admission resulting in the requirement of the item. We will not pay benefits without evidence of a hospital admission.

If eligible, we will pay 100% of the cost up to a maximum limit of $500 per person per calendar year for any hire or purchase of crutches or wheelchairs.

Excess

On selected covers there may be an excess option which may lower the amount that you pay for your cover. Excesses are only payable on overnight and same-day inpatient hospital admissions in any hospital.

  • The total excess amount is paid each time a person on your membership is admitted into hospital, to a maximum of once per person and twice per membership each calendar year unless otherwise specified.
  • If the total excess amount for an individual is not reached in a single hospital admission, the remaining balance of that excess is payable in any subsequent hospital admission.
  • No excess applies to your dependent children. Please contact us for further details.

What is not covered?

Hospital costs

Situations when you are likely not to be covered or may incur significant additional expenses include:

  • during a waiting period
  • when a service is excluded from your level of cover
  • when specific services or treatments are a restricted cover
  • labour ward fees on Short Stay Visitors Cover
  • when you are treated at a non-agreement hospital you will not be fully covered
  • for the fixed fee charged by a fixed fee hospital or a hospital that has a fixed fee service. This does not apply to Ultimate Corporate Visitors Cover as any fixed fee will be reimbursed
  • depending on your level of cover, if you have not been admitted into a hospital and are treated as an outpatient (eg emergency room treatment, outpatient ante-natal consultations with an obstetrician) you may not be covered
  • for psychiatric and rehabilitation day programs, at a hospital Bupa does not have an agreement with
  • hospital treatment provided by a practitioner not authorised by a hospital to provide that treatment
  • hospital treatment for which Medicare pays no benefit, including: medical costs in relation to surgical podiatry (including the fees charged by the podiatric surgeon); cosmetic surgery where not clinically necessary; respite care; experimental treatment and/or any treatment/procedure not approved by the Medical Services Advisory Committee (MSAC)
  • personal expenses such as: pay TV, non-local phone calls, newspapers, boarder fees, meals ordered for your visitors, hairdressing and any other personal expenses charged to you unless included in your cover
  • if you are in hospital for more than 35 days and you have been classified as a 'nursing home type' patient. In this situation you may receive limited benefits and be required to make a personal contribution towards the cost of your care
  • some hospital-subsititute treatment and operative services that are a continuation of care associated with an early discharge from hospital
  • for pharmacy items not opened at the point of leaving the hospital unless covered on your visitors or extras cover
  • if you choose to use your own allied health provider (eg chiropractors, dieticians or psychologists) rather than the hospital's practitioner for services that form part of your in-hospital treatment
  • where compensation, damages or benefits may be claimed by another source (eg workers compensation)
  • for any amount charged by a public or non-agreement hospital which is not covered by us or which is above the benefit that we pay
  • for any treatment or service rendered outside Australia
  • for any treatments arranged in advance of your arrival in Australia
  • Non-PBS, high cost drugs
  • if you do not hold a valid visa at the time of admission to hospital and for the duration of your hospital stay.

Medical costs

You will not be covered for:

  • medical services for surgical procedures performed by a dentist, surgical podiatrist, or any other practitioner or service that is not eligible for a rebate through Medicare
  • costs for medical examinations, x-rays, inoculation or vaccinations and other treatments required relating to acquiring a visa for entry into Australia or permanent residency visa.

Waiting periods - Hospital

A waiting period is the time when you are not covered for a particular service.  It starts on the date that you enter Australia or the date that you start your membership, whichever is the later date.  Once you have completed your waiting period, you will receive the benefits listed under your level of cover for that service.

Please note: you commence serving your waiting periods from the date you arrive into Australia, and not the start date.
 

Pregnancy and birth related services 12 months
Pre-existing conditions relating to psychiatric, rehabilitation and palliative care 2 months
All other pre-existing conditions, ailments, or illnesses 12 months

Understanding your ambulance cover

You will receive unlimited emergency ambulance services. That means we will pay 100% of the charges for emergency transportation and on-the spot treatment, by our recognised providers.

You will receive limited non-emergency ambulance services. This means your cover will be limited to three times per person, per calendar year, for non-emergency transportation by our recognised providers.

Recognised Ambulance Providers

Bupa will only pay benefits towards ambulance services when they are provided by any of the following recognised providers:

  • ACT Ambulance Service
  • Ambulance Service of NSW
  • Ambulance Victoria
  • Queensland Ambulance Service
  • South Australia Ambulance Service
  • St John Ambulance Service NT
  • St John Ambulance Service WA
  • Tasmanian Ambulance Service.

For more information about our working and non-working visitors covers, please refer to the Visitors Cover Brochure and Visitors Cover Important Information Guide.

Extras

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What is covered?

With extras cover, you can claim benefits for those services listed on your cover and that are not claimable elsewhere (e.g. from a third party like Medicare).

For example, Medicare does not provide benefits for:

  • most dental examinations and treatment
  • most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services
  • acupuncture (unless part of a doctor’s consultation) or other natural therapies
  • glasses and contact lenses
  • most health aids and appliances
  • home nursing

Extras cover allows you to claim benefits for extras services as long as:

  • the treatment is given by a private practice provider who is recognised and registered with us for benefit purposes
  • they meet the criteria set out in our policies and Fund Rules.

We recommend you contact us before making a booking to confirm how much you can claim and to check that your chosen provider is registered with us.

What is not covered?

Extras benefits will not be payable:

  • during a waiting period
  • where a third party, including Medicare, a Government body, or an insurance company provided a benefit (except for hearing aids and breast prosthesis items)
  • for different services within the same service type from the same provider on the same day. For example, if you went to see an acupuncturist and then received a massage from the same provider on the same day, you cannot claim for both services
  • when a prescribed treatment is not fully custom made (e.g. orthotics, surgical shoes)
  • when a provider is not recognised by us for benefit purposes
  • for any treatment or service rendered outside Australia
  • when you have reached the maximums on your product including annual, lifetime or service limits for the service you are claiming

Waiting periods

The following waiting periods apply for extras cover:

  • initial waiting period – two months
  • hire, repair and maintenance of health aids and appliances; and Health Management Extras Service – six months
  • major dental, orthodontics, selected health aids and appliances – 12 months

Extras Services

Services covered & example items

Benefits

Loyalty Maximums per person per calendar year

General dental

Periodic exam (012) 90% of cost

Yr 1: $1200
Yr 2: $1320
Yr 3: $1440
Yr 4: $1560
Yr 5: $1680
Yr 6: $1800

 

Scale & clean (114) 90% of cost
Fluoride application (121) 90% of cost
Tooth extraction (322) 90% of cost
Filling/tooth restoration (531) 90% of cost

Major dental

Root canal (417)

Full crown (615)

Dentures – Complete (719)

90% of cost

90% of cost

90% of cost

Combined with General dental

Orthodontics

  90% of cost

Combined with General dental
No lifetime limits for Orthodontics

Optical

Frames (110) 90% of cost $300 per person
Single vision lens (212) 90% of cost
Progressive lens (512) 90% of cost

Physiotherapy

Initial attendance 90% of cost

Yr 1: $550
Yr 2: $600
Yr 3: $650
Yr 4: $700
Yr 5: $750
Yr 6+: $800

Subsequent attendance 90% of cost

Post & Ante Natal services

90% of cost $400

Chiropractic/Osteopathy

Initial attendance

90% of cost
 

Yr 1: $550
Yr 2: $600
Yr 3: $650
Yr 4: $700
Yr 5: $750
Yr 6+: $800

Subsequent attendance

90% of cost
 

Psychology

Initial attendance 90% of cost

Yr 1: $700
Yr 2: $750
Yr 3: $800
Yr 4: $850
Yr 5: $900
Yr 6+: $950

Subsequent attendance

90% of cost

Podiatry

Initial attendance 90% of cost Combined limit with Psychology
Subsequent attendance 90% of cost

Dietary

Initial attendance 90% of cost $500 per person
Subsequent attendance 90% of cost

Speech therapy

Initial attendance 90% of cost Combined limit with Dietary
Subsequent attendance 90% of cost

Eye therapy

Initial attendance 90% of cost Combined limit with Dietary
Subsequent attendance 90% of cost

Occupational therapy

Initial attendance 90% of cost Combined limit with Dietary
Subsequent attendance 90% of cost

Natural therapies

Includes acupuncture, Alexander Technique, Chinese herbalism, exercise physiology, Feldenkrais,

homeopathy, iridology, massage, naturopathy and Western herbalism.

Massage includes aromatherapy, Bowen Technique, kinesiology, reflexology, shiatsu and remedial massage.

Acupuncture initial attendance 90% of cost Combined limit with Psychology
Acupuncture subsequent attendance 90% of cost
Massage 90% of cost

Pharmacy

Covers selected items. You pay a set amount then we refund 90% of the balance of the script.

Combined limit with Psychology

Health aids and appliances

Blood glucose monitor 90% of cost Combined limit with Psychology.

Sub limit of $100 for hire, repair and maintenance of health aids and appliances.
Asthma pump 90% of cost
CPAP devices 90% of cost
TENS machine 90% of cost
Blood pressure monitor 90% of cost
Hearing aids 90% of cost
Hire, repair and maintenance of health aids and appliances 90% of cost

Health Management

Our Health Management extras service helps you reach your goals by covering some of the costs for health-related programs including: nicotine replacement therapy, weight management programs and health subscriptions to Diabetes Australia and Asthma Foundation.


 

 

$100 per person

Home nursing

Covers selected services


90% of cost
$350 per person

Travel and accommodation expenses

Helps pay for travel and accommodation benefits for essential medical treatment.  

$100 for travel expenses

$40 per night for accommodation expenses, up to $150 per year.

Emergency Ambulance services

When provided by recognised providers Capped at 1 service per year for singles and 2 for couples/family
  • ADDITIONAL FEATURES

Gap free cover for kids

We will cover the cost of your kids on most dental, physio, chiro, podiatry consultations, and selected optical packages at Members First providers, up to yearly limits, and until your kids turn 25.*

*For most items covering dental, physio, chiro, podiatry consultations and selected optical packages. Available on Platinum Visitors Cover when taken on a family membership. Fund and policy rules and waiting periods apply. Child dependants only. Excludes orthodontics, orthotics and hospital treatments.

Add Pharmacy Saver

Enjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores. With Pharmacy Saver, you'll receive a 20% discount on a variety of health-related products. View details >

Pharmacy saver

Add Pharmacy Saver to your extras cover and enjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores available in VIC, NSW & SA.^ Also includes access to the National Pharmacies' website and online shopping facilities including online prescription requests available nationwide.

You'll get a 20% discount on a variety of health-related products.* Pharmacy Saver is not available for prescriptions on which the Government does not allow discounts. Visit a National Pharmacies store for more information.

* These are products designed to manage or prevent diseases, injuries or a condition, or prescribed in connection with an episode of hospital treatment.

^ Locations subject to change.

Weekly

Member Exclusives

Even when you’re in great health, there are still plenty of ways to get everyday value thanks to Bupa Plus. We’ve introduced this program to give you access to an exclusive range of discounts, health tools and information to help you live a healthier, happier life. Visit www.bupaplus.com.au

 
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From outside of Australia

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9am - 1pm AEST Sat
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